BVA9513706
DOCKET NO. 93-14 666 ) DATE
)
)
On appeal from the decision of the
Department of Veterans Affairs Regional Office in St. Paul,
Minnesota
THE ISSUES
l. Entitlement to service connection for boils, residuals
of meningitis, tinnitus, tension headaches, and disability
involving the left great toe.
2. Entitlement to an increase in the 40 percent evaluation
assigned for the residuals of a coccygeal fracture.
3. Entitlement to an increased (compensable) evaluation for
a benign mass on the medial aspect of the right tibia.
4. Entitlement to an increased (compensable) evaluation for
the residuals of a right knee injury.
REPRESENTATION
Appellant represented by: The American Legion
WITNESS AT HEARING ON APPEAL
Appellant
ATTORNEY FOR THE BOARD
B. P. Gallagher, Counsel
INTRODUCTION
The appellant had active service from December 1979 until
December 1989.
This matter comes before the Board of Veterans' Appeals
(Board) on appeal from rating decisions of the Department of
Veterans Affairs (VA) Regional Office (RO) of St. Paul,
Minnesota.
At the hearing in January 1992, the representative indicated
the appellant sought service connection for a right great toe
injury, although earlier in the hearing the issue of service
connection for a right foot injury had been dropped.
Accordingly, the issue of service connection for a right
great toe injury is referred to the RO for further
adjudication.
REMAND
The RO by rating action in April 1991 denied service
connection for boils as not found on the last examination.
The service medical records do disclose that the appellant
was treated for a probable infected sebaceous cyst on the
right buttock in August 1987. On the Department of Veteran’s
Affairs dermatology examination in December 1990, she did not
mention this problem and the examiner therefore did not
examine this area. At the hearing in January 1992, she
testified she always had boils on the right buttock and that
the infection developed in service.
On a VA audiometric examination in December 1992, the
appellant reported a history of constant tinnitus, and on the
ENT examination, the examiner stated she admitted to
occasional tinnitus and a positive history of noise exposure
in service. At the hearing it was reported that she worked
as an aviation technician in service for 10 years with
limited ear protection. Service personnel records will be
requested in support of this claim.
On the VA examination in December 1990, the appellant claimed
that she had primarily frontal headaches since an attack of
meningitis two years ago. When she had these headaches she
went to bed. She also claimed tension headaches associated
with stiffness and spasms in the neck. Headaches, most
likely tension headaches, were diagnosed and this condition
was denied by the RO on the basis that these were
constitutional or developmental.
Service connection for the residuals of a left great toe
disorder, including treatment for ingrown toenails was denied
on the basis that it was not shown on the last examination.
It is not clear that specific examination was undertaken.
Such examination will be requested as part of the development
requested herein.
In view of the foregoing and because the Board has a duty to
assist the appellant under 38 U.S.C.A. § 5107(a), this case
is remanded to the RO for the following:
1. The RO should attempt to ascertain
whether or not the appellant was exposed
to acoustical trauma during her service.
Her personnel records should be obtained
for review on this question. The
appellant should then be afforded another
special ENT examination. The claims
folder should be made available to the
examiner prior to the examination to
review the clinical history. The
examiner should express an opinion as to
whether the reported tinnitus most likely
had its onset during service.
2. The RO should arrange for the veteran
to have a special dermatological
examination to include an examination of
the right buttock area. The claims
folder should be made available to the
examiner prior to the examination to
review the clinical history. The
examiner should express an opinion as to
whether any abnormality involving the
right buttock, to include residual
scarring, if existent, is related to the
in-service cyst.
3. The RO should arrange for the veteran
to have a special neurological
examination. The claims folder must be
made available to the examiner prior to
the examination to review the clinical
history. The examiner should attempt to
ascertain whether the veteran’s headaches
are the result of the meningitis, or
whether there are any residuals of the
meningitis suffered in service, or if
they are tension headaches unrelated to
the meningitis but due to another
disability, to include the service
connected low back disability.
4. The RO should determine if there are
any clinical records, including VA
outpatient records of treatment of the
appellant’s service connected low back
and lower extremity disorders from early
1993. If so, the RO should attempt to
obtain copies of the records. Whether or
not there are any records, the RO should
arrange for a special examination to
determine the current extent of the
veteran’s service connected low back,
right knee and right tibia disorders.
The claims folder must be made available
to the examiner prior to the examination
to review the clinical history. All
clinical findings should be reported in
detail.
After the requested development has been completed the RO
should review the claim. If the benefits sought are not
granted, the veteran and her representative should then be
furnished a supplemental statement of the case and afforded a
reasonable opportunity to respond thereto. The case should
then be returned to the Board for further appellate action.
No action of the appellant is required until she is notified.
MICHAEL D. LYON
Member, Board of Veterans' Appeals
The Board of Veterans' Appeals Administrative Procedures
Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___
(1994), permits a proceeding instituted before the Board to
be assigned to an individual member of the Board for a
determination. This proceeding has been assigned to an
individual member of the Board.
Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the
Board of Veterans' Appeals is appealable to the United States
Court of Veterans Appeals. This remand is in the nature of a
preliminary order and does not constitute a decision of the
Board on the merits of your appeal. 38 C.F.R. § 20.1100(b)
(1994).